Using electronic health record data for substance use Screening, Brief Intervention, and Referral to Treatment among adults with type 2 diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network study.

Wu, Li-Tzy

Brady, Kathleen T

Spratt, Susan E

Dunham, Ashley A

Heidenfelder, Brooke

Batch, Bryan C

Lindblad, Robert

VanVeldhuisen, Paul

Rusincovitch, Shelley A

Killeen, Therese K

Ghitza, Udi E

United States

2015-12-03T17:21:54Z

2016-01

BACKGROUND: The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. METHODS: We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. DISCUSSION: By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions.

http://www.ncbi.nlm.nih.gov/pubmed/26563446

S1551-7144(15)30120-8

1559-2030

https://hdl.handle.net/10161/10996

eng

Elsevier BV

Contemp Clin Trials

10.1016/j.cct.2015.11.009

Diabetes

Home-based primary care

Medical comorbidity

Referral to treatment

Substance use disorder

Substance use screening

Comorbidity

Diabetes Mellitus, Type 2

Electronic Health Records

Feasibility Studies

Humans

Mass Screening

North Carolina

Patient Protection and Affordable Care Act

Primary Health Care

Prospective Studies

Referral and Consultation

Substance-Related Disorders

Using electronic health record data for substance use Screening, Brief Intervention, and Referral to Treatment among adults with type 2 diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network study.

Journal article

Wu, Li-Tzy|0000-0002-5909-2259

Batch, Bryan C|0000-0002-7138-2064

http://www.ncbi.nlm.nih.gov/pubmed/26563446

30

38

Center for Child and Family Policy

Clinical Science Departments

Community and Family Medicine

Community and Family Medicine, Community Health

Duke

Duke Clinical Research Institute

Duke Institute for Brain Sciences

Institutes and Centers

Institutes and Provost's Academic Units

Medicine

Medicine, Endocrinology, Metabolism, and Nutrition

Medicine, General Internal Medicine

Psychiatry & Behavioral Sciences

Psychiatry & Behavioral Sciences, Social and Community Psychiatry

Sanford School of Public Policy

School of Medicine

Staff

University Institutes and Centers

Published

46